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Metabolic Brain Disease

, Volume 29, Issue 4, pp 919–925 | Cite as

Elevated cerebral lactate: Implications in the pathogenesis of hepatic encephalopathy

  • Cristina R. BosoiEmail author
  • Christopher F. Rose
Research Article

Abstract

Hepatic encephalopathy (HE), a complex neuropsychiatric syndrome, is a frequent complication of liver failure/disease. Increased concentrations of lactate are commonly observed in HE patients, in the systemic circulation, but also in the brain. Traditionally, increased cerebral lactate is considered a marker of energy failure/impairment however alterations in lactate homeostasis may also lead to a rise in brain lactate and result in neuronal dysfunction. The latter may involve the development of brain edema. This review will target the significance of increased cerebral lactate in the pathogenesis of HE.

Keywords

Hepatic encephalopathy Lactate Brain edema Ammonia 

Abbreviations

HE

hepatic encephalopathy

MG

methylglyoxal

LDH

lactate dehydrogenase

TCA

tricarboxylic acid cycle

ANLS

astrocyte-neuron lactate shuttle

BBB

blood–brain barrier

MCT

monocarboxylate transporter

ALF

acute liver failure

CLD

chronic liver disease

DCA

dichloroacetate

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Hepato-Neuro LaboratoryCentre Hospitalier de l’Université de Montréal (CRCHUM)QuébecCanada

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